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PERMIT APPLICATIO"' <br />BUILDINI 9ECHANICAL. / PLIJMBING / SIGN �� 'RINKLER / DEMOLITIOiV <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: �� ,� � t��� �' .��. �,r �j ` PROPERTY TAX #: <br />LEGAL for new construction: Short Plat/subdivisi <br />No. (attach copy of long legal description) <br />BUILDING PERMIT APPLICATION , � <br />Existing Use of Building: S�� i�Cr �yr n fT� �. n t, <br />� `-'�`—�. <br />Proposed Use of Building: �u�� /e'% C G � , y � ieat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached SFR-Attached ❑Duplex ❑ ulti-Family�# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />(� > �-u.7�tc�� L��W ���=fpl7 f'G'i�tf'G!i'.t �,�h e�lj 4•-i�� ��h.fJ�4�L �%¢�Cj-4J�Ydl <br />�� l� � CC�, cf�rccsc�.1 un.''�� (.-����.�. `� f�fe'� cY�� ,�;�.c� � r 'Y�rs'�dPc , <br />. �, e f' yS'�- l','.-�, � <br />Contract Price of Work: <br />�ASSOCIATED BUILDING PERMI ���ir a��u�able): � <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New ,_ Addn _Alteration _Repair <br />Fixfures Lisf of Fixtures Fixfures Lisf of Fixfures <br />A/C - Air Handling Units Heat Pump <br />Forced Air Systems Unit Heater <br />Gas Piping Boiler <br />Water Heater Refrigeration <br />Gas Fireplace Wood Stove <br />Gas Range Ducting <br />Clothes Dryer Hookups Other: <br />Range Hood <br />Exhaust Fan <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br /># of Lisf of Fixtures # of List of Fixtures <br />Fixtures Fixtures <br />Toilet Backflow Preventer (Inside Bldg) <br />Bathtub Urinal <br />Lavatory (Wash Basin) Drinking Founfain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher Roof Drains <br />Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/Bar/Mop/etc.) Other: <br />ACKNOWLEDGEMENT. 1 have reviewed this applrcation and confirm the information contained herein is true and correcf. Work done pursuant to this permit must comply with <br />currenf federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must firsf be autliorized rn w�iting from the <br />Building Offrcial before being authorized under any circumstance. I am the owner, or 1 am authonzed by the owner of this property to peiform the work for which application is made, <br />and I comply wiih the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everetf Official Use Only <br />PERMIT # <br />��-,l� << r ��� ��, �/s/�� �� ���� � � �� 4-� �� � - <br />Owner/Authorized Agent Signature D ta� e (Revised 90/92/2095) <br />